JP4782687B2 - Swing type retractor blade assembly - Google Patents

Description

  This application claims the benefit of US Provisional Application No. 60 / 418,774, filed Oct. 15, 2002.

  The present invention relates to a retractor blade that is adjustably coupled to a retractor shaft, and more particularly, a retractor with a ball joint that allows free movement of the retractor blade relative to the retractor shaft while limiting its range of motion. It relates to a retractor blade coupled to the instrument shaft.

  Co-pending and co-owned patent application No. 10 / 113,663 shows a multi-position ratchet mechanism for coupling a retractor blade to a ring, which is incorporated herein by reference. To do. Although this 10 / 113,663 is not prior art, the development of the technology disclosed therein has helped the applicant determine that there is a need for the invention disclosed herein. Is.

  This new clamp allows the retractor blade to be coupled to the clamp via the retractor shaft when the clamp is coupled to the ring, or when the clamp is rocked down and inserted into the wound, or When swung from left to right, it is coupled to the retractor shaft as traditionally done in the prior art and as shown in US Pat. No. 4,354,763. A fixed mounting retractor blade cannot be held substantially perpendicular to the direction of traction. The retractor blade is most effective when proper traction occurs with the majority of the blade surface area facing the tissue (ie, the tissue is perpendicular to the traction direction).

  Thus, the development of a multi-position clamp as described in US patent application Ser. No. 10 / 113,663 improves the intermediate joint between the retractor blade and the retractor shaft to provide a multi-position ratchet mechanism or Whatever the angular relationship of the retractor axis with respect to another angle adjustable clamp, it has become necessary to maintain close contact of the retractor blade to the tissue.

By improving the intermediate connector between the retractor blade and the retractor shaft, the optimal area of the retractor blade is no matter what the angular position of the retractor shaft is relative to the clamp that connects the retractor shaft to the ring. It needs to be able to keep it facing the tissue.
Also, there is a need for an improved retractor blade assembly that can swing freely to an optimal traction position if the retractor axis is not necessarily oriented to follow a vector oriented in the traction direction.
In addition, if the retractor axis is not optimally oriented for traction, the ability to maintain the retractor blade perpendicular to the direction of traction is also required.

  As such, the retractor assembly consists of a retractor blade coupled via a base to a connector and a retractor shaft. The retractor shaft is preferably coupled to the ring by a rotatable and / or rockable clamp, but the ring need not be circular. Since the angle of the retractor shaft relative to the ring is adjustable at the clamp, the connector is considered to self-adjust the angle of the retractor blade relative to the retractor shaft. The connector is preferably a rocking connector, but other types can be used.

Since the ring is typically located proximal to the ridge of the incision, this preferred embodiment allows a limited travel in the up and down direction. The side-to-side, or lateral, travel of the retractor shaft relative to the base coupled to the retractor blade is in this preferred embodiment a range of motion of about 120 °, so that the connector Consideration is made to allow the retractor blade to swing relative to the retractor shaft with sufficient account for the displacement of the retractor blade relative to the ring in the pulling direction.
In this coupled form, the retractor blade is preferably coupled to the retractor shaft while allowing a target range of movement of the ball retractor blade relative to the retractor shaft.

Detailed features and advantages of the present invention and other objects will become apparent from the following description taken in conjunction with the accompanying drawings.
FIG. 1 shows an assembly 10 of the preferred embodiment. The assembly 10 consists of a retractor blade 12 having a base or shoulder 14. The assembly 10 also has a retractor shaft 16. The retractor shaft 16 and the retractor blade 12 are preferably coupled at a connector 18 which is a rocking coupling. Other connectors such as a ball joint type could also be used.
The component descriptions help to understand the expected positioning to demonstrate the capabilities of the assembly 10 shown in FIGS. The retractor shaft 16 preferably includes a plurality of notches 34 that allow a clamp 48 as shown in FIG. 6 to place the retractor shaft 16 in a target position relative to the ring 46 or other suitable structure. Can be constrained in a ratchet or other manner. The retractor shaft 16 preferably has a substantially upper cross section over most of its length and has a connector 36 at the distal end 38.

  The oscillating coupling is preferably configured to have a flange U link 20, which is coupled to the retractor shaft 16 by a pin 22. As shown in FIG. 1, the flange U link 20 is coupled to a swinging flange 24 that swings around a pin 26. Preferably, the flange U-link 20 can swing at least 60 degrees, but not 90 degrees, on either side of the retractor shaft axis 17. In another embodiment, the swing is possible in the range of +/− 30 degrees or +/− 45 degrees.

FIG. 4 shows a swinging flange 24 different from that of the assembly 10 shown in FIG. The oscillating flange 24 has an extension 28 which is received in the bore 30 of the blade mounting boss 32, which bosses, as shown in FIG. 14 and.
As shown in FIG. 1, the coupling portion 36 has a columnar shape having a through hole 40.
As shown in FIG. 2, the distal end 38 of the retractor shaft 16 is inserted into the receptacle 42 shown in broken lines in FIG. The pin 22 shown in FIG. 1 extends through the hole 44 and the through hole 40 of the coupling portion 36 and holds the retractor shaft 16 against the flange U link 20 as shown in FIG. This is expected to be a rigid and immobile joint, but in other embodiments this is not necessarily so.

  FIG. 3 shows a flange U link 20 having a slot 50 in which the hub 56 of the oscillating flange 24 shown in FIG. 4 is received. The hub may have a circular peripheral portion, but may be configured to have stoppers 60 and 62 as shown in FIG. When the stopper is assembled to the slot 50 as shown in FIG. 1, the hub 56 swings about 60 degrees on the left and right of the axis 17 of the retractor shaft around the rotation axis 60 in cooperation with the slot 50. Is exceeded. In another embodiment, the slot 50 can serve to limit the angular movement of the hub 56 independently of the hub or other structure stoppers 60, 62. In another embodiment, the hub 56 can be configured to allow more than 90 degrees of swinging of the retractor shaft axis 17 from side to side. The pin 26 holds the hub 56 in the slot 50 shown in FIG. 3, while allowing the hub 56 to swing. Another holding part, such as a ball joint or the like, can be used to achieve this retention and movement ability. It should be understood that the term “pin” is a generic term and can be used to mean a screw, column, or other coupling means.

The extension 28 of the oscillating flange 24 is received in the hole 30 of the blade mounting boss 32 as shown in FIG. The pin 68 extends through the extension through hole 64 and the side slot 66 so that the pin 68 is not only received, but at least relative to the axis 17 of the retractor shaft about the tilt axis 70. Only a limited angle, eg, plus / minus less than about 20 degrees, can be swung. The tilt axis 70 is preferably positioned at right angles to the swing axis 60 and at a distance.
The shoulder 14 of the blade 12 is clamped in the mouth 72 of the blade mounting boss 32 and the coupling pin 74 helps restrain the shoulder 14 in the gripper 72 depending on the tolerance of the shoulder 14 relative to the mouth 72.

  The clamp 48 is shown in FIG. 6 as a virtually single box, but may have more structures, as shown in co-pending US patent application Ser. No. 10 / 133,663, Alternatively, the retractor shaft 16 may have another clamping configuration indicating that the retractor shaft 16 can be configured to pivot relative to the ring 46 about the axes 52,54. It has been attempted to insert the retractor blade 12 into the wound by pivoting the retractor shaft 16 into the incision, but the retractor blade is conventionally rigidly coupled to the retractor shaft 16 in the prior art. It had been.

  Thus, when the retractor shaft 16 is pivoted downward by the clamp 48, the tissue contact surface 76 shown in FIG. 1 is aligned with the axis 52 by the retractor shaft 16 clamped against the ring 16 in the case of the prior art retractor. It is inclined at an angle similar to the angle inclined downward about the center. Therefore, the connector 18 according to the present invention has a tissue contact surface 76 adjacent to the tissue 58 (in the traction direction) as shown in FIG. 6 even when the retractor shaft 16 pivots downward about the axis 52. Is considered to be maintained at a right angle).

  In addition, if the clamp 48 pivots about the axis 54 relative to the ring 46 and / or a plane extending through the axis 54 and the retractor shaft 16 is perpendicular to the tissue contacting surface 76 extending through the shoulder 14. If the clamp 48 is positioned so that it does not intersect the plane, the tissue contacting surface 76 can still maintain contact with the tissue 56. This is because the slot 50 allows the hub 56 around the pivot axis 60 to rotate, swing and pivot laterally to the tissue contacting surface 56 of the base 14 and retractor blade 12 as shown in FIG. This is because it is considered that the optimum contact with the tissue 58 is maintained.

In this preferred embodiment, the hub 56 pivots freely about the axis 60 within the slot 50 as needed, but in another embodiment, the slot 50 is in the desired position when needed. The hub 56 is configured to lock. In this preferred embodiment, the pin 68 is also free to move within the side slot 66 so that it can move up and down about the tilt axis.
The ring 46 known in the art does not necessarily have a circular periphery, and some types of rings may be substantially straight. In addition, there are multiple clamps 48 of a type different from the clamps described and illustrated in co-pending application 113,663, which also utilize the assembly 10 illustrated and described herein. Can do.

  Most retractor shafts 16 have a square cross section along a straight length, although other cross sectional shapes can be used in accordance with the present invention. Further, depending on the specific use prediction and the angular relationship of the shoulder 14 with respect to the retractor shaft 16, the angular distance can be adjusted in both lateral directions (ie from side to side and from top to bottom). This appears to assist in holding the tissue contact surface 76 against the tissue 58 at the incision. The preferred range of motion from top to bottom is less than +/− 30 °, more specifically about +/− 20 °, and the preferred range of motion from side to side is about 120 °, although these angles Can be limited and / or expanded depending on the specific requirements of the retractor system and assembly 10 utilized.

  Those skilled in the art will envision many other types of structures disclosed herein. It should be understood, however, that the form disclosed herein is a preferred embodiment of the present invention, which is illustrative only and not intended to be limiting. All such various modifications that do not depart from the spirit of the invention are intended to be included within the scope of the claims.

1 is a top perspective view of a retractor blade assembly having a retractor blade coupled to a retractor shaft by a connector according to a preferred embodiment of the present invention. FIG. Example 1 The perspective view which looked at the axial part of the retractor blade assembly shown in FIG. 1 from the side. The perspective view which looked at the flange U link of the retractor blade assembly shown in FIG. 1 from the upper side. The perspective view which looked at the rocking | fluctuation flange of the retractor blade assembly shown in FIG. 1 from upper direction. The perspective view which looked at the blade attachment boss | hub of the retractor blade assembly shown in FIG. 1 from the side. FIG. 2 shows a practical use of a retractor blade coupled with a retractor shaft according to the present invention, with one arbitrary point indicated by a broken line.

Explanation of symbols

10 retractor (retractor) blade assembly 12 retractor blade 14 shoulder and base of blade 16 retractor shaft 18 joint 20 flange U link 22 pin 24 rocking flange 26 pin 28 rocking flange extension 30 blade mounting boss Hole 32 Blade mounting boss 34 Notch 36 Connector 38 Distal end 40 Connector hole 42 Connector receiving portion 44 Hole 46 Ring 48 Clamp 50 Slot 52 Axis 54 Clamp axis 56 Hub 58 Tissue 60, 62 Stopper 64 Extension hole 66 side Slot 68 Pin 70 Tilt axis 72 Mouth opening 74 Binding pin 76 Tissue contact surface

Claims (9)

In the retractor (tractor) assembly,
A support;
A clamp that can be selectively positioned at a target location on a support;
A retractor shaft coupled to the clamp, which is also a retractor shaft extending from the clamp and the support and further having a shaft end, the retractor shaft axis extending through said shaft end, wherein the retractor shaft A retractor axis comprising a retractor axis plane extending vertically through the axis of the retractor axis;
A connector coupled to the retractor shaft at the shaft end of the retractor and spaced apart from the clamp and support by a length along the axis of the retractor shaft via the retractor shaft;
A retractor blade coupled to the connector, the retractor blade being angularly positionable about the axis of the retractor axis relative to the horizontal plane of the tilt axis, the horizontal plane of the tilt axis being perpendicular der relative to the retractor shaft plane extending vertically through the axis of the retractor shaft is,
The connector includes an oscillating flange connected to the retractor blade via a blade mounting boss, the oscillating flange being oscillatable about the axis of rotation, thereby enabling the retractor blade to rotate about the axis of rotation. , the axis of rotation that is oriented at right angles to the the tilt axis the axis of the retractor shaft, retractor assembly. The retractor assembly of claim 1, wherein the swing flange allows lateral movement of the retractor blade about the swing axis within a range of +/- 60 degrees relative to the axis of the shaft. .   The retractor assembly according to claim 2, wherein the tilt axis is spaced from the swing axis and is perpendicular to the swing axis.   The retractor assembly of claim 1, further comprising a stopper in the connector that limits angular movement of the retractor blade.   The retractor assembly according to claim 1, wherein the support is a retractor support ring.   The retractor assembly according to claim 1, wherein the retractor shaft is substantially straight and extends along the axis of the retractor shaft. The connector further includes a flange U-link coupled to the retractor shaft, the U-link receiving an oscillating flange coupled to the base of the retractor blade, and the oscillating flange is centered about the oscillating axis. The retractor assembly of claim 1, wherein the retractor assembly is swingable. Retractor before Symbol blade mounting bosses at the base of the blades are attached, a retractor assembly according to claim 7.   The retractor assembly of claim 8, further comprising a side slot provided in the blade mounting boss, wherein the blade mounting boss is coupled via a pin held by the side slot.

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